Preadoption medical evaluation of a child
The interaction between a health care professional and a potential adoptive family at the time of a child’s referral is not only an opportunity for education on the medical condition of a child but also the best chance for influencing parental expectations about their future adoption experience. However, without a different set of lenses than used to evaluate a child raised by a competent family, evaluating a child who experienced early adversity may not accurately communicate potential risks and benefits to the parents. The goal of this first part of the symposium to lay the groundwork for knowledgeably and productively discussing medical risks with parents as well as facilitating a dialog about appropriate expectations when future challenges are anticipated. Based on experience of over 25,000 preadoption medical reviews as well as a survey involving 2,300 international adoptees from Minnesota, the following topics will be addressed:
1. Common prenatal risks
2. Short and long-term effects of institutional care.
3. Quality of foster care
4. Structure, capacity and quality of medical care systems.
5. Idiosyncratic medical terminology.
6. Routine screening tests that should be expected
7. Additional tests that might be available and those that likely aren’t.
8. Interpretation of growth information from different caregiving environments.
9. Interpretation of developmental information for children living in different caregiving environments.
10. Spectrum of diagnoses in specific countries.
11. Benefits to the family of medical review.
12. Counseling families about living with uncertainty.
13. Setting appropriate expectations for children with complex medical/developmental problems.
14. “Red Flags” in the history that portent great stress or adoption/family disruption.
15. How accurate are predictions?